13 September 2012

Bacteria lurk behind sinus infections

A small new study offers insight into the germ warfare that goes on inside the heads of people with chronic sinus infections.

A small new study offers insight into the germ warfare that goes on inside the heads of people with chronic sinus infections. Harmless bacteria become superpowered and create trouble in the sinuses of affected people, the findings suggest.

The research doesn't seem likely to immediately help relieve long-lasting sinus infections, which can be extremely difficult to treat and cause intense misery in sufferers. But the study could open the door to greater understanding of the disease, said study co-author Susan Lynch, an associate professor of medicine at the University of California, San Francisco.

"This may be why some patients never recover," she said. "There's promise of maybe having an alternative approach to treatment."

Bacteria and sinus

Sinus infections are defined as chronic when they last for more than three months. Bacteria can cause them, often after a cold, and they lead to swelling and lots of mucus production. Viruses and allergies can also cause sinus infections.

The US Centers for Disease Control and Prevention estimates that at least 30 million adults in the United States suffer from diagnosed sinus infections.

The new study examines what happens in the sinuses of infected people, which -- like other parts of the body -- are home to bacteria that aren't normally harmful.

Researchers looked into the sinuses of 10 people with chronic sinus infections and 10 healthy people. They found evidence that normally benign bacteria become superpowered and turn bad, possibly because other bacteria aren't around to keep them in check.

Why does this happen? Possibly because antibiotic treatment for sinus infections focuses on getting rid of bad bacteria, which creates an opening for good bacteria to multiply and become a problem, Lynch said. The next step, she said, is to test new treatments in humans that keep this in mind.

Factors in sinus infections

Dr Jordan Josephson, a sinus and allergy specialist at Lenox Hill Hospital in New York City, cautioned that the picture is even more complicated because of the presence of other things in the sinuses, such as fungus.

Another sinus specialist, Dr Reginald Baugh, chair of otolaryngology at the University of Toledo in Ohio, agreed that other factors are part of sinus infections. "Additional studies are indicated to replicate and further substantiate their findings," he said.

Baugh added that the findings of the study sound reasonable. It's possible, he said, that doctors have done the wrong thing by targeting germs for death instead of focusing on harmony among bacteria in the sinuses.

It may make more sense to emphasise "harmony within the bacterial community rather than the scorched-earth policy of antibiotic therapy," he said. "Whether or not it is effective remains to be proven."

Ask the Expert

Dr Heidi van Deventer completed her MBChB (Bachelor of Medicine and Bachelor of Surgery) degree in 2004 at the University of Stellenbosch.
She has additional training in ACLS (Advanced Cardiac Life Support) and PALS (Paediatric Advanced Life Support) as well as biostatistics and epidemiology.

Dr Van Deventer is currently working as a researcher at the Desmond Tutu Tuberculosis Centre at the University of Stellenbosch.

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